Provider Demographics
NPI:1306659594
Name:HAMILL, KEELEY ELIZABETH
Entity type:Individual
Prefix:
First Name:KEELEY
Middle Name:ELIZABETH
Last Name:HAMILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 E HILL PKWY APT 111
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-3313
Mailing Address - Country:US
Mailing Address - Phone:815-687-4736
Mailing Address - Fax:
Practice Address - Street 1:2802 COHO ST STE 204
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-4521
Practice Address - Country:US
Practice Address - Phone:608-940-5614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8271-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional